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NPI Code Detail

MEDICARE: MRS. KRISTA DENOFF RBT

MEDICARE: MRS. KRISTA DENOFF RBT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianRBT-19-103871FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104460906
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KRISTA DENOFF RBT
Provider Business Mailing Address
First Line : 1450 FREEPORT DR
Second Line :
City : DELTONA
State : FL
Zip : 32725-5939
Country : US
Telephone Number : 386-956-8406
Fax Number :
Provider Business Practice Location Address
First Line : 454 FORT FLORIDA RD
Second Line :
City : DEBARY
State : FL
Zip : 32713-9714
Country : US
Telephone Number : 386-968-2012
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2019
Last Update Date : 11/05/2019

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